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COVID-19 Vaccination: Fertility, Pregnancy and Breastfeeding

Before the third wave of the pandemic, there were mixed messages about getting the COVID-19 vaccine if you were planning a pregnancy, pregnant, or breastfeeding. The sharing of disinformation on social media platforms fuelled much of the concern.

Getting vaccinated is your choice. We want you to feel confident in your decision. It's really important to make sure you understand as much as you can about COVID-19 and the vaccine so you can make an informed choice.

Recommendations

The Society of Obstetricians and Gynaecologists of Canada, National Advisory Committee on Immunization and Ministry of Health recommend you get a complete series with an mRNA COVID-19 vaccine if you're pregnant or breastfeeding as soon as possible. Pregnant people can get vaccinated against COVID-19 at any time during pregnancy or while breastfeeding. The recommendation to get vaccinated also includes people who are trying to get pregnant now or who might become pregnant in the future.

Why the recommendation changed

Earlier in the pandemic, we had only limited data that could support evidence-informed recommendations about the COVID-19 vaccine for pregnant and breastfeeding populations. Pregnant and breastfeeding individuals were encouraged to talk to their treating health care provider and weigh the risks and benefits to determine if they should get the vaccine or wait for more information.

We now have more than a year of experience showing outcomes of people and their babies. No safety concerns were identified in a study of more than 35,000 pregnant people who received an mRNA COVID-19 vaccine within 30 days of conception. This real-world evidence shows that mRNA COVID-19 vaccines are safe for people who are pregnant or breastfeeding. As well, we have evidence of significantly increased risk for pregnant women and their unborn child if they do get COVID-19 infection.

There are two large Canadian studies that are now looking further at the safety and effectiveness of vaccines given to pregnant and breastfeeding individuals in the country.

Benefits of being fully vaccinated

  • Initial studies from Public Health Ontario show no concern for fertility in vaccinated individuals
  • Studies on those who have received the COVID-19 vaccine while pregnant have not shown any safety concerns for the pregnant individual or developing baby
  • There are currently no known harmful effects to your baby or increased risks of miscarriage or birth defects
  • There is no need to avoid starting or stopping breastfeeding if you get vaccinated
  • Emerging evidence suggests that you protect your baby from COVID-19 by getting vaccinated:
    • Anti-COVID-19 antibodies can be transferred to the developing fetus through the placenta
    • Anti-COVID-19 antibodies produced by a breastfeeding person can transfer through the milk and provide protection to the baby

This means you can be reassured that you are protecting yourself and your baby by getting vaccinated.

Learn more about what being fully vaccinated means and why a second dose is needed.

Understand the risks of being infected with COVID-19 while you're pregnant

  • If you contract COVID-19 during pregnancy, you will not be able to access in-person health care services you depend on for the health of your baby while self-isolation, for example prenatal appointments and ultrasounds.
  • COVID-19 may cause more severe illness in pregnant people than in people of the same age who are not pregnant
  • Intubation of a pregnant individual is considered higher risk to both the individual and their baby
  • Pregnant individuals with COVID-19 have a higher risk of delivering prematurely and needing a caesarean delivery. There is also a higher risk of having their baby admitted to the Newborn Intensive Care Unit

See Better Outcomes Registry and Network analytics for COVID-19 infections in pregnant individuals reported in Ontario. A national dataset of cases of COVID-19 in pregnancy is also in progress.

Possible COVID-19 vaccine side effects

Like any medication, vaccines may cause mild side effects and reactions. Vaccine side effects usually happen within a few days, and always within six weeks.

Vaccines are quickly broken down and removed from your body, so they will not cause side-effects many months or years later. The only lasting impact of vaccination is the training it provides your immune system to help your body fight the COVID-19 infection.

Frequently asked questions

General information

  • I'm not at higher risk for getting COVID-19. Why should I get vaccinated?

    At this point in the pandemic, people who are unvaccinated are likely to get infected. Please consider the very real risks of COVID-19 to you and your children.

    According to the Canadian Paediatric Society, although most children with COVID-19 require only supportive care, infants are at higher risk for severe COVID-19 infections. Clinical trials are underway for infants and children under five years of age. You can protect them now by getting vaccinated and following public health measures.

  • Should I wait until there is more information about the long term safety of mRNA vaccines?

    No. Don't wait to get vaccinated. Vaccines are quickly broken down and removed from your body. The only lasting impact of vaccination is the training it provides your immune system. Health Canada approved vaccines have passed quality and safety standards.

    Health Canada posts weekly reports on vaccine safety. Careful, ongoing monitoring of the COVID-19 vaccines will continue. There is also longer-term follow-up of those who were vaccinated as part of the clinical trails.

  • Is my baby at risk for COVID-19 infection?

    Evidence shows that it's rare to pass COVID-19 to your baby during pregnancy. Once your baby is born, they can get COVID-19 from other people, so it's important to limit their contact with others and follow public health measures.

    If you get vaccinated during your pregnancy, the antibodies that the mRNA vaccines produce will transfer across the placenta, providing protection to your baby.

    Learn more about caring for a newborn during COVID-19.

Fertility

  • What do I need to know about COVID-19 vaccination and menstruation?

    According to Public Health Ontario's evidence brief on COVID-19 vaccines and fertility, there is no evidence of an association between COVID-19 vaccination and menstrual irregularities to date. Several clinical studies are in progress and evidence will continue to be monitored.

    Factors like stress, anxiety and nutrition can affect menstruation. Changes to the menstrual cycle have been reported following infection with COVID-19 and in women affected by long-COVID. It's important that anyone experiencing menstrual disorders and / or unexpected vaginal bleeding, such as post-menopausal bleeding, seek medical advice.

  • What do I need to know about COVID-19 vaccination and male fertility?

    According to Public Health Ontario, there is no evidence to date to suggest that COVID-19 vaccination impacts male fertility. Studies evaluating male sperm parameters before and after receiving two doses of mRNA vaccine have not demonstrated differences. Evidence has shown a rare impact on male fertility after COVID-19 infection .

  • What if I am planning a pregnancy?

    Unless otherwise contraindicated, couples or individuals planning to conceive should receive the COVID-19 vaccination as soon as possible. To learn more about contraindications, visit "What medical exemptions are accepted for the COVID-19 vaccine?" .

  • Can the vaccine impact my ability to get pregnant?

    No. According to the Society of Obstetricians and Gynecologists of Canada, there is no evidence or reason to suspect that the COVID-19 vaccine could impair male or female fertility.

    While the proteins syncytin-1 (used for placental implantation) and the SARS-CoV-2 spike protein have several similar amino acids, they remain vastly different. The antibodies produced against the SARS-CoV-2 spike protein will not block syncitin-1.

    The concern around fertility seems to have started as a random Internet rumour that has gained traction. This rumour is false. Some people who voice this concern speak of "fertility research" around this vaccine. However, no such research exists. This is all driven by rumors. Overwhelmingly, medical science experts agree that currently there is no evidence of an increased risk of infertility after COVID-19 vaccination. Check the reliability of any online news before sharing.

    Unfortunately, during the third wave, people who were pregnant were at high risk of being hospitalized with COVID-19. If anything, those planning to become pregnant soon have a greater need to be vaccinated than others.

Pregnancy

Breastfeeding

  • Can I get the vaccine if I'm breastfeeding?

    Yes. You can get any of Canada's approved COVID-19 vaccines when you're breastfeeding. The National Advisory Committee on Immunization preferentially recommends that a complete vaccine series with an mRNA COVID-19 vaccine be offered to breastfeeding individuals.

    Recent data shows that mRNA from vaccines don't transfer into breast milk. Anti-COVID-19 antibodies produced by the breastfeeding person have been shown to transfer through the milk and provide protection to the infant. The vaccines are safe for the breastfeeding person.

More resources

  • Pregnant During the Pandemic: Dominique Denver's story
  • World Health Organization: Vaccines, pregnancy, menstruation, lactation and fertility
  • A peer-reviewed study on the ability of the COVID-19 mRNA vaccine to provoke an immune response in pregnant and lactating women
  • Niagara Region Public Health: Becoming a Parent and Pregnancy (general information, not COVID-19 related)
  • Contact

    Talk to your health care provider about the decision to get vaccinated.

    For questions about COVID-19 vaccination, call the COVID-19 Info-Line at 905-688-8248 or 1-888-505-6074, press 7.

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